Individual provider Active NPI

Deaunte Bruce Thompson, MD

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1205090156
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D75128 Issued in MD
Practice address
1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone
(865) 305-9350
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-13068 AR
Family Medicine Physician 207Q00000X D75128 MD Primary

Addresses

Primary practice location

1924 Alcoa Hwy
Knoxville, TN 37920-1511

Mailing address

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 305-9352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, AR, MS4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20130108000117 DC Practitioner - Family PracticePractitioner - Emergency Medicine 5496929093 Reassigns benefits to 1 organization
I20170817002842 MD Practitioner - Family Practice 5496929093 Reassigns benefits to 1 organization
I20200803001083 AR Practitioner - Family PracticePractitioner - Emergency Medicine 5496929093 Reassigns benefits to 1 organization
I20260601000548 MS Practitioner - Emergency Medicine 5496929093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

2100 N 7TH St
West Memphis, AR 72301-2017
Phone (870) 394-7800

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-13068ARMDEmergency Medicine Physician
D75128MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Jun 20, 2017 Accepting new patients
Medstar Urgent Care LLC CurrentSince Jun 20, 2017 Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Medstar Urgent Care, LLC Current Accepting new patients
Francis J. Fenaughty MD, P.C. Emergency Medicine Past Accepting new patients
T M Carr MD PC Emergency Medicine Past Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1205090156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEAUNTE",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-13068",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D75128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.